EXERGAME INTERVENTION TO PROMOTE FAMILY CAREGIVERS’ SOCIAL SUPPORT, PHYSICAL ACTIVITY, AND WELL-BEING

Abstract Family caregivers often experience high stress, social isolation, poor mental and physical health, and have a sedentary lifestyle. The current study was a randomized trial (Nf76) comparing the effectiveness of Go&Grow (social vs non-social exergame app) to promote well-being through increased social support and physical activity for family caregivers over a 6-week intervention. Both groups received daily reminders to use the app. Findings showed the treatment group increased significantly more than the control group in well-being (management of distress) and social support (satisfaction with contact quality). There was an indirect effect of change in social support in which the treatment group increased more than the control group in satisfaction with contact quality, which in turn led to more positive affect and less loneliness. The increase in steps ranged from 3% to 12% across conditions. Social support moderated the relationship between condition and step changes, such that those in the treatment group who increased more in overall social support and knowing others’ experiences increased steps more than those with less support, while change in steps for the control group was not related to support level. In the treatment group, those who used the social features of the app more frequently had a greater increase in steps compared to those who used the social features less often. These findings can offer new insights into implementing behavior change mechanisms using exergames for sedentary and socially isolated family caregivers to improve their health with modifiable behavioral factors such as physical activity and social support.

(OR=2.30, 95% CI=1.51-3.51). Caregivers with lower socioeconomic backgrounds are at higher probability of low healthcare literacy level. Our study suggests further longitudinal and qualitative research, to understand healthcare literacy level among informal caregivers, and how social support systems correlates to healthcare literacy level.

FACTORS ASSOCIATED WITH VOLUNTEERING AMONG FAMILY CAREGIVERS OF OLDER ADULTS
Sol Baik, 1 Rachel Coleman, 2 and Jennifer Crittenden 2 , 1. University of Virginia Weldon Cooper Center for Public Service,Charlottesville,Virginia,United States,2. University of Maine,Bangor,Maine,United States Family caregiving has been linked to an increased risk of poor mental health, poor physical health, and higher rates of perceived social isolation among caregivers. Despite the connection between caregiving and negative outcomes, or perhaps because of this connection, caregivers seek out and enjoy other life roles and activities including formal volunteerism. To explore the connection between informal caregiving and volunteering and establish the representative prevalence of formal volunteering among caregivers, descriptive and multivariate logistic regression analyses were carried out with data from 1,745 caregivers in the National Study of Caregiving (NSOC) (2017). Utilizing social capital theory four models were constructed with salient demographic characteristics associated with volunteering (model 1), caregiving context (model 2), caregiver physical and mental health (model 3), along with participation in informal and formal social networks (model 4). About a quarter of the sample participated in volunteering (26%). The average age was 60.5 years (SD = 14.3) and more than half consisted of female caregivers (67.11%). Non-Hispanic Whites (62.9%) were the majority of the sample, followed by non-Hispanic Blacks (28%), Hispanic (6.5%), and caregivers in other racial/ethic groups (2.6%). Gender, educational achievement, caregiving for a spouse, coresiding with care recipient, caregiving for multiple care recipients, quality of relationship with care recipient, caregiver psychological well-being, having emotional/physical support, attending religious services, and group activity participation were all significant indicators for caregiver volunteerism. Findings support the importance of both human and social capital in volunteering among caregivers.

EXERGAME INTERVENTION TO PROMOTE FAMILY CAREGIVERS' SOCIAL SUPPORT, PHYSICAL ACTIVITY, AND WELL-BEING Xin Yao Lin, and Margie Lachman, Brandeis University, Waltham, Massachusetts, United States
Family caregivers often experience high stress, social isolation, poor mental and physical health, and have a sedentary lifestyle. The current study was a randomized trial (Nf76) comparing the effectiveness of Go&Grow (social vs non-social exergame app) to promote well-being through increased social support and physical activity for family caregivers over a 6-week intervention. Both groups received daily reminders to use the app. Findings showed the treatment group increased significantly more than the control group in well-being (management of distress) and social support (satisfaction with contact quality). There was an indirect effect of change in social support in which the treatment group increased more than the control group in satisfaction with contact quality, which in turn led to more positive affect and less loneliness. The increase in steps ranged from 3% to 12% across conditions. Social support moderated the relationship between condition and step changes, such that those in the treatment group who increased more in overall social support and knowing others' experiences increased steps more than those with less support, while change in steps for the control group was not related to support level. In the treatment group, those who used the social features of the app more frequently had a greater increase in steps compared to those who used the social features less often. These findings can offer new insights into implementing behavior change mechanisms using exergames for sedentary and socially isolated family caregivers to improve their health with modifiable behavioral factors such as physical activity and social support.

CAREGIVING BURDENS OF TASK TIME AND TASK DIFFICULTY AMONG PAID AND UNPAID CAREGIVERS OF PERSONS LIVING WITH DEMENTIA
Matthew Smith, 1 Chung Lin Kew, 1 Gang Han, 1 Lucas Wilson, 1 Shinduk Lee, 2 John Fitch, 1 and Marcia Ory 1 ,

Texas A&M University, College Station, Texas, United States, 2. University of Utah, Salt Lake City, Utah, United States
Demands of caregivers of persons living with dementia (PLWD) are often influenced by the context of their caregiving situation. This study examines factors associated with caregiving burden in terms of task time and task difficulty among paid and unpaid caregivers of PLWD. Crosssectional baseline survey data were analyzed from 110 paid and unpaid caregivers of PLWD participating in a larger NIH-funded study assessing the feasibility of using a novel in-situ sensor system. Oberst Caregiving Burden Scale constructs of task time and task difficulty served as dependent variables. Two least squares regression models were fitted, controlling for contextual items related to the caregiver, care recipient, and caregiving logistics. Caregivers whose care recipients were female (B=-0.29, P=0.006), had more chronic conditions (B=0.31, P=0.011), and had lower Mini-Mental State Exam scores (B=-0.20, P=0.015) reported higher task time burdens. Caregivers whose care recipients had other paid caregivers (B=0.30, P=0.031) and spent more months/ years caring for their care recipients (B=0.28, P=0.004) reported higher task time burdens. Caregivers' task time burden was positively associated with their emotional stress level (B=0.30, P=0.020). Caregivers' task difficulty burden was positively associated with their emotional stress (B=0.30, P=0.029) and depressive symptomatology (B=0.32, P=0.002). Results reinforce the relationship between caregiver burden and mental health. While the care recipient's disease profile and needs were drivers of task time burden, which may also require coordination with other paid caregivers, task difficulty was emotionally driven. Findings highlight the importance of caregiver support services and programming for mental health. Deborah Watman,and Jennifer Reckrey,1. Icahn School of Medicine at Mount Sinai,New York City,New York,United States Paid caregivers (e.g., personal care aides, home health aides, other direct care workers) provide essential care that allows people with dementia to remain living at home, yet little is known about the lived experience of this care. This project uses multiple perspective, qualitative longitudinal interviews to explore paid caregiver role in home-based dementia care. We conducted one-on-one interviews via telephone or zoom with the family caregiver, paid caregiver, and geriatrician of an individual person with moderate or severe dementia (n=9) living at home in New York City. After an initial interview, up to 2 additional interviews (at 3 and 6 month intervals) were also conducted for a total of 75 interviews with 29 unique respondents. Interviews were audio-recorded, transcribed, and analyzed using the framework method of analysis. Interviews revealed nuanced care arrangements, but paid caregiver role in care remained largely stable over time. Key findings include: (1) Family caregivers played a primary role in determining overall paid caregiver role in care, (2) Paid caregivers describe the emotional components of caregiving (e.g. being "like family", having patience) more frequently than families or doctors, and (3) Doctors rarely engage with paid caregivers unless family involvement is limited. The unique structure of each triad emphasizes the importance of person-centered dementia home care. Formal care plans may not reflect the nuances of care arrangements and responsibilities. Rather than prescriptive standards for home care, improved communication and clear expectation setting may help meet the complex needs of people with dementia and their families.